HEPATIC IRON STORES AND PLASMA FERRITIN CONCENTRATION IN PATIENTS WITH SICKLE-CELL-ANEMIA AND THALASSEMIA MAJOR
HEPATIC IRON STORES AND PLASMA FERRITIN CONCENTRATION IN PATIENTS WITH SICKLE-CELL-ANEMIA AND THALASSEMIA MAJOR
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DOI：
10.1002/ajh.2830420116
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发表时间：
1993-01-01
影响因子：
12.8
通讯作者：
HARRIS, JW
中科院分区：
文献类型：
--
作者：
BRITTENHAM, GM;COHEN, AR;HARRIS, JW
为了研究接受红细胞输注和铁螯合治疗的个体中肝脏铁储备与血浆铁蛋白浓度之间的关系，对37例镰状细胞性贫血和74例重型地中海贫血患者进行了研究。在每例患者中，肝铁储备通过独立验证的非侵入性磁性方法进行测量，血浆铁蛋白通过免疫测定法进行测定。镰状细胞性贫血和重型地中海贫血患者的肝铁与血浆铁蛋白均呈显著相关（R = 0.75，P < 0.0001），重型地中海贫血患者的肝铁与血浆铁蛋白呈显著相关（R = 0.76，P < 0.0001）。回归分析表明，两组之间的肝铁储备和血浆铁蛋白之间的线性关系没有显着差异。以111例输血患者为一组，肝铁储备与血浆铁蛋白的相关系数非常显著（R = 0.76，P < 0.0001）。回归分析发现，体内铁储备的变化，通过磁测定肝铁的评估，仅占血浆铁蛋白变化的约57%，这表明其余的是其他因素的结果，如溶血，无效红细胞生成，抗坏血酸缺乏症，炎症和肝脏疾病。考虑到血浆铁蛋白，肝脏铁浓度的95%预测区间太宽，以至于血浆铁蛋白的单一测定不能可靠地预测体内铁储备。铁状态以外的因素引起的变异性限制了血浆铁蛋白浓度作为体内铁储存预测因子的临床实用性。
To examine the relationship between hepatic iron stores and plasma ferritin concentration in individuals treated with red cell transfusion and iron chelation therapy, 37 patients with sickle cell anemia and 74 patients with thalassemia major were studied. In each patient, hepatic iron stores were measured by an independently validated noninvasive magnetic method, and plasma ferritin was determined by immunoassay. The correlation between hepatic iron and plasma ferritin was significant both in patients with sickle cell anemia (R = 0.75, P < 0.0001) and in those with thalassemia major (R = 0.76, P < 0.0001). Regression analysis showed no significant difference between the two groups in the linear relationships between hepatic iron stores and plasma ferritin. Considering all 111 transfused patients as a group, the coefficient of correlation between hepatic iron stores and plasma ferritin was highly significant (R = 0.76, P < 0.0001). Regression analysis found that variation in body iron stores, as assessed by magnetic determinations of hepatic iron, accounted for only approximately 57% of the variation in plasma ferritin, suggesting that the remainder was the result of other factors, such as hemolysis, ineffective erythropoiesis, ascorbate deficiency, inflammation, and liver disease. The 95% prediction intervals for hepatic iron concentration, given the plasma ferritin, were so broad as to make a single determination of plasma ferritin an unreliable predictor of body iron stores. Variability resulting from factors other than iron status limits the clinical usefulness of the plasma ferritin concentration as a predictor of body iron stores.